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Emotion Response Patterns to Transient Stimuli in Migraineurs and Non-Migraineurs Modulation of Affective States As a Step Towards Non-Invasive Treatment of Migraine

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Emotion Response Patterns to Transient Stimuli in Migraineurs and Non-Migraineurs Modulation of Affective States As a Step Towards Non-Invasive Treatment of Migraine UNIVERSIDADE DE LISBOA FACULDADE DE CIÊNCIAS FACULDADE DE LETRAS FACULDADE DE MEDICINA FACULDADE DE PSICOLOGIA EMOTION RESPONSE PATTERNS TO TRANSIENT STIMULI IN MIGRAINEURS AND NON-MIGRAINEURS MODULATION OF AFFECTIVE STATES AS A STEP TOWARDS NON-INVASIVE TREATMENT OF MIGRAINE Ana Pesquita MASTER IN COGNITIVE SCIENCE 2010 UNIVERSIDADE DE LISBOA FACULDADE DE CIÊNCIAS FACULDADE DE LETRAS FACULDADE DE MEDICINA FACULDADE DE PSICOLOGIA EMOTION RESPONSE PATTERNS TO TRANSIENT STIMULI IN MIGRAINEURS AND NON-MIGRAINEURS MODULATION OF AFFECTIVE STATES AS A STEP TOWARDS NON-INVASIVE TREATMENT OF MIGRAINE Ana Pesquita Thesis supervised by Prof. A.M. Sebastião, PhD co-supervised by Prof. Dr. P.F.M.J. Verschure MASTER IN COGNITIVE SCIENCE 2010 ACKNOWLEDGMENTS During the making of this thesis I have encountered many people who contributed in different ways to the work and to the enrichment of the personal experience that it constituted. For their supervision, I want to thank Ana Sebastião and Paul F.M.J. Verschure. For creating a space for discussions on Cognitive Science inside Lisbon University, I want to thank the Scientific Committee of the Master in Cognitive Sci- ence and all the remarkable folks I encountered during these studies. The initial phase of this work was developed under the financial support of the INOV-Art Scholarship, an initiative of the Portuguese Ministry Of Culture. Synthetic Perceptive Emotion Cognition Systems Laboratory (SPECS), at Pompeu Fabra University, supported the development of this work and contributed deeply to the scientific insights in it ex- pressed. Aleksander Valjamae supervised the initial phase of this master thesis and, together with Paul F.M.J. Verschure, is the author of the original idea of the AMDB system. Arnau Espinosa and Eliza-Nefeli Tsaoussi collaborated on software devel- opment and testing. My thanks also go to Patricia Pozo-Rosich and Joan Durà from the Hospital Vall D’Hebron, and to the Nexes association for their tireless efforts in the search for participants. Special thanks go to all the women who participated in the empirical study, without whom the development of this work would not have been possible. I seize this moment to express my huge gratitude to my family, a clan of wise thinkers and brave doers. Finally, my last thank you is saved for Ulysses Bernardet, the author of the first implemented version of the AMDB software, that was the starting point of my contribution to this SPECS project. Ulysses’ energetic mind and sincere heart balanced their presence in every step of this journey, and for that I feel extremely grateful. ABSTRACT This thesis was developed in the context of the scientific study of emotion, and focuses on the modulation of affective states through perceptual stimuli. Two goals were pur- sued during the course of this master project. Firstly, the development of the Affective Multimodal Data Base (AMDB) system, a tool for multimodal emotion induction, and secondly, to conduct an empirical study, using the AMDB, that aimed at probing the modulation of affective response patterns in migraineurs. The AMDB system is a software platform for generating affective stimuli by com- bining sounds, pictures and videos, available in normalized affective stimuli libraries, into multimodal stimuli sequences to be used in emotion induction scenarios. Con- tributions of this master project to the development of the AMDB system include the addition of a graphical-user-interface, implementation of synchronized stimuli presen- tation and physiology response recording, improvement in the modular implementa- tion of the system, and finally, realization of the first test-case of the AMDB system. It was decided to focus the empirical study on migraine, because it is a widespread pathology that presents a clear link with emotion mechanisms. The empirical study aimed at investigating dynamic patterns of affective responsiveness and modulation in migraineurs with aura. The findings from this study suggest an affective profile spe- cific to migraineurs with aura characterized by an enhanced impact of unpleasant stim- uli, potentiation of negative affective states when repeatedly exposed to non-pleasant stimuli, and high susceptibility to disrupt positive affective states in the presence of unpleasant and neutral environmental stimuli. This study hopes to contribute to the understanding of affective response patterns specific to migraine, and to provide insights for the design of therapy approaches to migraine based on emotion modulation, that could in the future help migraine sufferers ease the disease burden through the use of accessible media technologies. Keywords: emotion modulation, affective profile, migraine, pain, non-invasive therapy RESUMO Esta dissertação foi desenvolvida no contexto do estudo científico da emoção, e foca a modulação de estados afectivos através de estímulos perceptuais. O progresso deste trabalho foi guiado por dois objectivos principais: primeiro, o desenvolvimento do sistema Affective Multimodal Data Base (AMDB), uma ferramenta para indução de estados afectivos; e segundo, a realização de um estudo empírico, utilizando o AMDB, com o objectivo de examinar a modulação de padrões de respostas afectivas em pessoas que sofrem de enxaqueca com aura. O sistema AMDB é uma plataforma de software para a geração de estímulos afec- tivos através da combinação de sons, imagens estáticas e vídeos a ser utilizados em contextos de indução de estados afectivos. Contribuições deste mestrado para o de- senvolvimento do AMDB incluem a adição de um interface gráfico para o utilizador, a implementação de apresentação de estímulos e gravação de respostas fisiológicas de forma sincronizada, melhoramentos na implementação modular do sistema, e por fim, a realização de um primeiro caso de teste do AMDB. A decisão de focar o estudo empírico, desenvolvido dentro do âmbito deste tra- balho, na patologia da enxaqueca foi motivada pelo facto desta ser muito difundida e apresentar relações claras com os mecanismos de emoção. Os resultados deste es- tudo sugerem um perfil afectivo específico às pessoas que sofrem de enxaqueca com aura caracterizado por susceptibilidade intensificada a estímulos desagradáveis, po- tenciação de estados afectivos negativos em situações de repetida exposição a estímu- los neutros ou desagradáveis, e disposição aumentada para a interrupção de estados afectivos positivos na presença de estímulos ambientais de cariz emocional neutro ou desagradável. Este estudo espera contribuir para a compreensão dos padrões de respostas afec- tivas específicos na patologia da enxaqueca, servindo como ponto de partida para o design de abordagens terapêuticas baseadas na modulação de estados afectivos. Palavras-chave: modulação de respostas emocionais, perfil afectivo, enxaqueca, dor, terapias não-invasivas SUMÁRIO O estudo da emoção foi abraçado pela neurociência e ciência cognitiva apenas re- centemente. Os enigmas da emoção, uma função complexa do cérebro intimamente ligada à experiência subjectiva e ao comportamento, foram durante um longo período de tempo deixados fora do cerne científico. No século passado, a investigação da emo- ção proliferou inspirada pela busca de conhecimento acerca de como a emoção modula o comportamento e funções cognitivas como a atenção, a memória e a tomada de de- cisões. Tendências na neurociência focaram-se nos fundamentos neurofisiológicos da emoção, e é agora aceite que a emoção é um importante interveniente para a compre- ensão holística da mente e do cérebro. É neste contexto da ciência da emoção que a presente dissertação foi desenvolvida. O objectivo central deste trabalho foi investigar a modulação de padrões de respostas afectivas em pessoas que sofrem de enxaqueca. A decisão de focar a enxaqueca, uma patologia que envolve episódios severos de dor de cabeça, foi motivada pelo facto da enxaqueca ser uma condição clínica que apresenta relações claras com os mecanismos de emoção. A enxaqueca é também um tópico de interesse dado ser um problema globalmente pouco reconhecido e pouco tratado. A Organização Mundial de Saúde (OMS) anunciou números relevantes que colocam a enxaqueca entre as maiores causas de incapacidade. Recentemente, o papel da emoção na modulação da dor tem recebido especial aten- ção devido a vários estudos que, por um lado suportam o importante contributo da elaboração cognitiva para o desenvolvimento de estratégias por parte dos pacientes para lidar com a dor, e que por outro lado sugerem que mecanismos neurofisiológicos ligados ao processamento emocional influenciam a modulação de nocicepção. Conse- quentemente, a compreensão da dimensão da emoção nas desordens de dor crónica está actualmente no cerne do desenvolvimento de abordagens terapêuticas não-invasivas, que pretendem contribuir para o alívio do peso da dor nas vidas de pessoas que sofrem deste tipo de condições clínicas. O estudo empírico desenvolvido no âmbito deste trabalho teve como objectivo exa- minar as respostas a estimulação afectiva de pessoas que sofrem de enxaqueca. Em particular, foi estudada a flexibilidade na adaptação das resposta afectivas a mudanças no contexto da estimulação afectiva. No sentido de abordar o objectivo de investigação proposto desenvolvi duas tarefas em separado: 1. Colaboração no desenvolvimento de uma ferramenta de software para modula- ção de estados afectivos utilizando estímulos multi-modais, o sistema Affective Multimodal Data Base (AMDB) 2. Realização de um estudo empírico, utilizando o sistema AMDB, junto de uma Sumário VIII amostra da população
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